JACC: CARDIOVASCULAR INTERVENTIONS
VOL. 9, NO. 11, 2016
ª 2016 BY THE AMERICAN COLLEGE OF CARDIOLOGY FOUNDATION
ISSN 1936-8798/$36.00
PUBLISHED BY ELSEVIER
http://dx.doi.org/10.1016/j.jcin.2016.03.015
IMAGES IN INTERVENTION
A Foreign Body Inside the Pulmonary
Artery After Heart Transplantation
Chan Joo Lee, MD, PHD,a Hyun-Chel Joo, MD,b Jong Yun Won, MD, PHD,c Seok-Min Kang, MD, PHDa
A
40-year-old man with a history of hypertro-
(Figure 1D), which was supposed to be an unpleasant
phic cardiomyopathy, progressive dyspnea
gift from the donor heart. The patient discharged
and refractory ascites was referred to our
2 days later without complication. We speculate
hospital for heart transplantation. The patient un-
that the donor had a central venous catheter and it
derwent heart transplantation successfully from fe-
was accidently acquired with donor heart during pro-
male donor who died of intracranial hemorrhage.
curement, and then migrated into the left pulmonary
After heart transplantation, the patient recovered
artery after heart transplantation. This case demon-
uneventfully and discharged 1 month later. By
strates routine examination of donor heart is a key
chance, we found a linear opacity around the left hi-
to suspect the presence of a foreign body including
lum on the follow-up chest x-ray, 3 months later. On
the possibility of an amputated central venous
the review of the series of chest x-ray, it was also
catheter.
visible on immediate post-operative chest x-ray
(Figure 1A, black arrow). Chest computed tomogra-
REPRINT REQUESTS AND CORRESPONDENCE: Dr.
phy showed a foreign body inside the left main pul-
Seok-Min Kang, Cardiology Division, Department of
monary artery (Figure 1B, solid arrow). He received
Internal Medicine, Yonsei University College of
percutaneous
body
Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul
removal and it (Figure 1C, solid arrow) was success-
120-752, Republic of Korea. E-mail: [email protected].
intervention
for
a
foreign
fully retrieved with a snare (Figure 1C, open arrow).
It was a long fragment of the central venous catheter
KEY WORDS central venous catheter, foreign body, heart transplantation
From the aDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea;
b
Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea; and
the cDepartment of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of
Medicine, Seoul, Korea. All authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Manuscript received February 24, 2016; accepted March 11, 2016.
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Lee et al.
JACC: CARDIOVASCULAR INTERVENTIONS VOL. 9, NO. 11, 2016
A Foreign Body Inside the Pulmonary Artery
JUNE 13, 2016:1191–2
F I G U R E 1 Foreign Body in the Chest X-Ray After Heart Transplantation
(A) Linear foreign body on post-operative chest X-ray. (B) High-opacity material inside the left pulmonary artery on chest computed
tomography. (C) Percutaneous foreign body retrieval with a loop snare wire. Solid arrow indicates the foreign body. Open arrow
indicates the loop snare wire. (D) Amputated central venous catheter.